Individual
JULIE LEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10940 FAIRFAX BLVD STE D1, FAIRFAX, VA 22030-4301
(571) 321-5430
Mailing address
PO BOX 69020, BALTIMORE, MD 21264-9020
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305211255
VA
Other
Enumeration date
08/04/2017
Last updated
08/10/2022
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